Are we getting it right about perimenopause?

YOU are in your thirties or forties, the insomnia is unbearable, you can’t remember names and the littlest things have started irritating you…. does this sound familiar?

It could be perimenopause. This is the time leading up to the menopause, where the hormones oestrogen, progesterone and testosterone start to fluctuate.

Did you know that symptoms may begin years before menopause is officially diagnosed, which is a retrospective diagnosis, 12 months after your final period?

But why are some of us still not connecting the dots?

At this stage, your periods may be normal and changes to your body are vague or subtle — restless legs, skin crawling, palpitations, “burning” tongue, gum disease and hair loss.

These are just some of the other symptoms I hear, with women commonly being offered treatments such as antidepressants instead of hormone replacement.

For many perimenopausal and menopausal women, there isn’t a hot flush in sight, a symptom often used to definitively diagnose menopause.

But how do we know?

When symptoms are so vague, making the right diagnosis is not always straightforward.

Of course, not everyone with anxiety or sleep issues is perimenopausal and the cause of these conditions is often complex and multifactorial.

But we should be seriously considering perimenopause as a possible cause for puzzling symptoms in this key age range.

A patient recently came to see me and said: “I was driving on the motorway to work, something I have done for years, and all of a sudden, I had an impending sense of anxiety and couldn’t continue the journey. I couldn’t understand what was happening to me.”

This was just the start of a domino effect of symptoms such as those described above.

I told her to keep a record of her symptoms on a calendar and the hormonal link soon became clear. Symptoms alone are usually enough for diagnosis.

We don’t tend to recommend blood tests as they are often inaccurate due to fluctuating hormones during this phase of life.

Tracking symptoms month by month can help you and your doctor pinpoint emerging patterns and get the right help you need.

What treatments are available?

Some women sail through this important chapter. Sadly, for others it has huge negative impact on quality of life.

Did you know you don’t need to wait for your periods to stop to begin treatment?

Treatments include physical- and psycho-therapies, non-hormonal medications and hormone replacement therapy (HRT). Menopause is not a “one size fits all” and treatments should be tailored to your individual needs.

Look after yourself

It can be tricky to look after yourself if you are trying to navigate a busy lifestyle, all the while battling debilitating symptoms.

But with proper support, healthy lifestyle practices can help improve mental and physical wellbeing around menopause and the years to follow — reducing alcohol and caffeine consumption, prioritising sleep, having a balanced diet, taking regular exercise and not smoking can all be beneficial.

Take home message

So why is it so important to get help? There is a wealth of benefit of taking treatments such as HRT, especially within 10 years of the menopause or under the age of 60.

In fact, those having early, or premature, menopause are more at risk of long-term health conditions such as osteoporosis, heart disease and cognitive decline when starting treatment early can prevent these detrimental effects.

Don’t minimise your symptoms and if any of this sounds familiar, start that diary!